Diabetic muscle infarction is a rare complication of diabetes that occurs in patients with type 1 diabetes (70% of total cases) or in patients with poorly controlled type 2 diabetes.1 It presents with sudden onset of a painful swelling, often of the thigh, which is bilateral in up to a third of patients, and it occurs spontaneously without a history of trauma or features of infection.2 Diabetic muscle infarction is under-recognised and often misdiagnosed,3 4 and treated as rhabdomyolysis or polymyositis. A high index of suspicion is needed to make a timely diagnosis and to avoid the use of steroids or surgical intervention. This report highlights the clinical investigations, laboratory tests, and imaging scans needed to establish the clinical diagnosis in a timely fashion to avoid unnecessary and possibly harmful interventions.